Chair of the Council of Deans of Health

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Presentation on theme: "Chair of the Council of Deans of Health"— Presentation transcript:

1Chair of the Council of Deans of HealthSue BernhauserDean of the School of Human & Health Sciences, University of Huddersfield,Chair of the Council of Deans of Healthand Commissioner

2Sometimes I think I understand everything, then I regain consciousness.

3STRESS The following picture has 2 identical dolphins in it.It was used in a case study on stress levels at an NHS hospital. Look at both dolphins jumping out of the water.The dolphins are identical. A closely monitored, scientific study revealed that, in spite of the fact that the dolphins are identical, a person under stress would find differences in the two dolphins.The more differences a person finds between the dolphins,the more stress that person is experiencing.

4STRESS The following picture has 2 identical dolphins in it.It was used in a case study on stress levels at an NHS hospital. Look at both dolphins jumping out of the water.The dolphins are identical. A closely monitored, scientific study revealed that, in spite of the fact that the dolphins are identical, a person under stress would find differences in the two dolphins.The more differences a person finds between the dolphins,the more stress that person is experiencing.

7Introduction The Commission was a year-long process…Why was it needed?Who was involved?What did we do?Nurses and midwives are responsible for so much of what we have achieved over the last 10 years. They are experts who know best how the service can meet the needs of patients and their local communities. We must be bold in putting them in control and at the heart of our plans for a world-class NHS.Prime Minister Gordon Brown, launching the Commission on 10 March 2009

8Why was the Commission needed?First overarching review of nursing and midwifery since 1972Changing health needsMajor advances in treatment and careRising public expectationsNursing and midwifery needs to be better understood, developed and supportedChanges need to go further, faster

9Who led the work?Chaired by nurse MP Ann Keen, Parliamentary Under Secretary for Health Services20 Commissioners – expert nurses and midwives from practice, management, education, research and policy-makingSupport Office hosted by Department of HealthThe debate exposed many myths and misunderstandings about nursing, perhaps above all the mistaken idea that compassion can be separated from competence. Compassion is vital, but it is not enough: nurses and midwives must also be well educated to deliver safe, effective care.Ann Keen MP, Chair of the Commission

10What the Commission didExtensive engagement with the public, service users, nursing and midwifery staff, other professionals and stakeholder organizations. Activities included:National listening events in London and ManchesterEvents in all 10 NHS strategic health authoritiesStakeholder events including a students’ dayDebate via the media and the Commission’s websiteRound table discussions, one hosted by the Prime Minister.We received over 2500 submissions, representing the views of many thousands of people, and supporting evidence

12The context Socioeconomic, health and demographic trendsThe Commission analysed nursing and midwifery today in the context of:Socioeconomic, health and demographic trendsThe education, continuing professional development and supervision needed to meet future needsManagement and workplace culturesWe then developed:A value-based vision of the future that sees nurses and midwives in the mainstream of service planning, development and delivery20 high-level recommendations

13Our vision: six dimensions1 High quality, compassionate careNurses and midwives will champion, deliver and coordinate physical and psychosocial care for every service user, family and carer, throughout the care pathway, and be supported in doing so2 Health and wellbeingNurses and midwives play important roles in health promotion, disease prevention and maintaining health and wellbeing. They champion health and wellbeing at work and elsewhere

14Our vision: six dimensions3 Caring for people with long-term conditionsNurses’ central role in the care and support of people with long-term conditions and the complex health needs of ageing will be recognised and enhanced4 Promoting innovation in nursing and midwiferyNurses and midwives will work in new ways and sometimes new roles in response to service users’ needs

15Our vision: six dimensions5 Nurses and midwives leading servicesNurses and midwives will be confident and effective leaders and champions of care, with a powerful voice at all levels of the health system6 Careers in nursing and midwiferyNursing and midwifery offer worthwhile, appealing careers with high levels of responsibility and autonomy, plus opportunities for personal and professional development and fulfilment

17Meeting the challenge…Considerable investment is made in developing nursing and midwifery capital – but its potential is underdevelopedBasic and continuing education need further investment and improvement, especially with the move to degree levelWorkplace cultures and teams need to be more supportiveThe public image needs updating

18Meeting the challenge…The impact of nursing and midwifery on health and health care should be better evaluated. The Commission made two specific recommendations:1 Evaluate nursing and midwiferyGaps in evidence-based evaluation of nursing and midwifery must be identified to see what further research is needed2 Measure progress and outcomesThe development of a framework of explicit, nationally agreed indicators and outcomes for nursing and midwifery must be accelerated

20The nursing and midwifery pledgeNurses and midwives must declare their commitment to society and service users in a pledge to give high quality care to all and tackle unacceptable variations in standardsThe pledge complements the NMC Code, the NHS Constitution and other professional codes and regulatory standards. Nurses and midwives must use it to guide their practice, adapting it to their work settings, and regulators and employers must ensure that their codes, policies and guidance on nursing and midwifery support it.The Commission

21The pledge… The pledge asks every nurse and midwife to:Uphold the NMC Code and the NHS ConstitutionTake personal responsibility for delivering effective, evidence-based, high quality careAcknowledge that service users are partners in their careLive up to the responsibility of being seen as role models for healthy livingEngage with policy-making and decision-making

22Recommendations In addition to the pledge, we make19 further recommendations that reflect the outcomes of our engagement process and provide a Call to ActionThey cover the six key themes outlined above

23Theme 1: high quality, compassionate careSenior nurses and midwives’ responsibility for careUphold the pledgeAccept full individual accountability for careMaintain clinical credibilityChampion high quality care from point of care to boardCorporate responsibility for careHealth boards must accept full accountability for commissioning and delivering high quality careBoards must appoint directors of nursing to champion careCultures and structures must recognise and support senior nurses and midwives to deliver high quality care

24More on Theme 1… Protecting the title ‘nurse’The title ‘nurse’ should only be used by those registered by the Nursing & Midwifery CouncilRegulating advanced practiceNMC must regulate advanced nursing practice and define required competenciesConsider advanced level regulation for those working in specialist or consultant rolesRegulating support workersGovernment and stakeholders to review and recommend type and level of regulation of non-registered staff

25Theme 2: health and wellbeingNurses and midwives’ contribution to health and wellbeingNurses and midwives should be supported to turn every interaction into a health improvement opportunityActive engagement in service design and monitoringA named midwife for every womanTo ensure coordination of care, reduction of inequalities and provision of support and guidanceStaff health and wellbeingNurses and midwives must recognise they are role models, and take personal responsibility for their health and wellbeingEmployers must care for the carers’ health and wellbeing

26Theme 3: caring for people with long-term conditionsNursing people with long-term conditionsGreater recognition for nurses’ lead roleCare pathways must maximise nursing contributionAll barriers to effective practice must be removed, for example to enable direct referrals from nurses to other professionals and agenciesFlexible roles and career structuresNurses must be competent and willing to work across the full range of health and social care settingsFlexible career structures must be designed to support this

27Theme 4: promoting innovationBuilding capacity for innovationNursing and midwifery fellows should be appointed to promote innovation in service design and delivery, as champions of change and leaders of transformational teamsDevelop entrepreneurial skillsMaking best use of technologyEstablish a high-level group to determine how to build nursing and midwifery capacity to understand and influence the development and use of new technologies.

28Theme 5: nurses and midwives leading servicesStrengthening the role of the ward sisterTake immediate steps to strengthen this linchpin role in hospital and equivalent in midwifery and communityClearly defined authority and lines of accountability for clinical lead roles, which must drive quality and safetyNo more than two levels between sister and nursing directorFast-track leadership developmentRegional schemes must be established to develop and support potential nursing and midwifery leadersSuccessful candidates who reflect the diversity of the workforce must be fast-tracked to roles influencing care delivery

29Theme 6: careers in nursing and midwiferyEducating to careFully implement degree-level registration of all new nursesEffective revalidationGreater investment in continuing professional developmentMarketing nursing and midwiferyTell a new story of nursing and midwiferyPosition this career as a good choiceRecruit high-calibre candidates of all ages and backgroundsIntegrating practice, education and researchFacilitate sustainable clinical academic career pathwaysFurther develop research skills

31The next stepsThe 20 high-level recommendations provide an ambitious agenda and call to actionActing on this agenda would provide an excellent return on the public investment in nursing and midwiferyIt will require sustained effort and commitment from the Government, employers, educators and other stakeholdersAnd from nurses and midwives!This will require nothing less than the renewal and revitalisation of nursing, and full recognition of the autonomy of midwifery. It will demand honesty about where things are going wrong, and commitment to making the systemic, social and cultural changes needed to put them right. We urge you to support us, and all nursing and midwifery staff, in our quest to deliver world-class health care to the people of England in the 21st century.Commendation from the Commissioners

32What can I do? Encourage debate on the reportHold meetings in your workplace, union, professional organizationDiscuss it with colleagues, managers, Chief Executives, other professionalsThink about what needs to change in your workplaceThink about how it relates to your own workUse the recommendations as a lever for change and a platform for campaigningContact your SHA lead nurse to get involved in their strategies

33Campaigning tools All available at cnm.independent.gov.ukFull report and recommendationsExecutive summaryLeaflet for service usersDVD of the report launchPromotional DVDAll available atcnm.independent.gov.uk